Percussion data in the lungs rather scanty: most celebrated louder sound due to emphysema, at least

As can be concluded from the above data pathogenesis and pathological anatomy, the clinical picture of pulmonary fibrosis should dominate phenomena caused by chronic bronchitis, emphysema, heart hypertrophy and dystrophy. This actually occurs. It must be emphasized that there are often not only chronic bronchitis, bronchiectasis but. From the standpoint of clinical manifestations useful to distinguish without fibrosis bronchiectasis and pulmonary fibrosis with bronchiectasis. Here we present the clinic without fibrosis bronchiectasis. On questioning patients suffering pneumosclerosis pay attention perennial often repeated bronchitis, pneumonia and influenza, which actually represent the periodic flare-up. Exacerbations occur most often in the winter season; sometimes they are repeated regularly in spring and autumn.
The main complaint is a cough. Sometimes he stretches from childhood that usually indicates the connection with disease of childhood infections (measles, whooping cough); it is often possible to establish that the cough was recovering from influenza focal pneumonia, rarely after lobar pneumonia, especially symptoms of strep throat if the disease differed protracted course. Cough associated with chronic bronchitis, as mentioned symptoms of strep throat above.
Depending on the features of bronchitis, its prevalence on the bronchial tree it may be dry or be accompanied by a small branch or a large number of mucopurulent or purulent sputum mainly. At a certain stage of the disease in some patients observed blood in the sputum, which indicates ulcerative bronchitis.
Dyspnea does not appear immediately, but with the progression of the disease symptoms of strep throat it is marked as a rule. At first she felt only on exertion, later revealed at the slightest effort, for example, during a conversation; still later it becomes constant, even at rest. Dyspnea associated with pulmonary and later heart failure. In some patients the asthmatic attacks periodically, especially after coughing fit.
Appearance of patients is relatively good for a long time. Sometimes puffy face; in the later stages of the face cyanotic. Low or increased low-grade; during exacerbations temperature for several symptoms of strep throat days and sometimes symptoms of strep throat weeks 1-2 may be at 38-39 .
Percussion data in the lungs rather scanty: most celebrated louder sound due to emphysema, at least - a slight dulling under the shoulder blades. symptoms of strep throat Usually a lot of wheezing is heard. Some patients have numerous scattered wheezes, others, besides, many and moist rales, the third moist rales (finely) tapped mainly under the shoulder blades in the paravertebral areas. Wheezing symptoms of strep throat sometimes resemble those crackling machine gun, they are often mistaken for pleural friction rub. X-ray examination of the lungs reveals usually small changes. They reduce to elevated pulmonary tissue transparency, indicating emphysema, and pulmonary pattern enhancement through peribronhiticheskih changes; sometimes visible dense linear strands due to bronchitis and peribronhita. During exacerbations can be detected is volatile pneumonic shadow. Persistent homogeneous shadow symptoms of strep throat with irregular outlines can be detected pnevmoskleroze that developed symptoms of strep throat as a result of suffering a lung abscess. Cellular symptoms of strep throat shade indicates generally bronchiectasis.
Heart long retains normal size; even if there are already signs of heart failure in the form of an enlarged liver and sensitive and small swelling in the legs heart can still be unexpanded. Only in the later stages of the enlargement of the heart is determined mainly by the right heart. Perkutorno definition prevents this expansion often expressed emphysema. X-ray study of the same, except for the increased size of the heart, often reveals bulging arc of the pulmonary artery, as well as extended and dense shade roots of the lungs due to advanced pulmonary artery symptoms of strep throat branches. Heart tones changed little. Sometimes they are weakened because of emphysema at the apex of the heart and a base; at the lower end of the sternum same tones usually distinct, often reinforced.
Red blood little changed; stage heart failure in red blood cell count is often increased symptoms of strep throat to 6000 500 000 000-6, erythrocyte sedimentation rate slowed. Leukocyte count is usually not increased during the same exacerbations increases to 10 000-15 000 in 1 mm3.
In the clinical course of pulmonary fibrosis can often as particularly stressed Rubel, to trace the three phases of the disease: compensated, and decompensated subcompensated. symptoms of strep throat In the first stage compensated fibrosis may occur secretly, with no complaints symptoms of strep throat from the patient and without objective changes. But even in this stage, patients become symptoms of strep throat Hypersensitivity to cooling, atmospheric influences; In addition, the latent period is interrupted from time to time "colds," bronchitis. During these exacerbations temperature rises, a cough with phlegm, interlayer